Sleep duration and quality in heart failure patients

Area of Science:

• Cardiology
• Sleep Medicine
• Pulmonology

Background:

• Sleep-disordered breathing (SDB) is common in heart failure with reduced left ventricular ejection fraction (HF-REF).
• SDB subtypes include obstructive sleep apnea (OSA) and central sleep apnea (CSA).
• SDB can negatively impact sleep quality, duration, and overall quality of life.

Purpose of the Study:

• To characterize sleep quality and duration in well-defined HF-REF patient cohorts.
• To compare sleep parameters between HF-REF patients with OSA and CSA.

Main Methods:

• Two hundred fifty consecutive HF-REF patients (NYHA class ≥II, ejection fraction ≤45%) underwent comprehensive cardiac and pulmonary evaluations.
• In-hospital attended overnight polysomnography (PSG) was conducted for all participants.
• PSG data were analyzed independently at a core laboratory according to established recommendations.

Main Results:

• Patients with HF-REF and CSA were older and exhibited more impaired cardiac function than those with OSA.
• CSA patients had longer time in bed (468 ± 52 min vs. 454 ± 46 min) but lower sleep efficiency (67 ± 14% vs. 72 ± 13%) compared to OSA patients.
• CSA patients experienced more wake time after sleep onset (101 ± 61 min vs. 71 ± 46 min) and increased light sleep (stage N1: 33 ± 19% vs. 28 ± 16% of TST).
• Overall, deep sleep (N3) was notably low in HF-REF patients with SDB (4.1 ± 6.3% of TST).

Conclusions:

• HF-REF patients with CSA demonstrate significantly worse sleep efficiency and quality compared to those with OSA.
• These sleep disturbances may lead to reduced restorative sleep and altered physiological regulation.
• Impaired sleep quality in CSA could contribute to poorer cardiovascular outcomes in HF-REF patients with SDB.